Adopt the Right Mindset for Board Exams

March 25, 2024


The initial United States Medical Licensing Examination (USMLE Step 1) and Comprehensive Osteopathic Medical Licensing Examination (COMLEX-USA Level 1) are widely considered to be among the most difficult exams in higher education. Both are high-stake assessments of a student’s acquired knowledge of basic sciences. Failure can have a devastating effect on a student’s future, so adopt the right mindset for board exams.

“Medical students typically take the USMLE [Step 1] or COMLEX-USA [Level 1] at the end of their second year of med school,” says Dr. Hans Wolf, the founder of WOLFPACC’s Physician Achievement Concept Course. “Board exams differ from other standardized tests as they assess the student’s mastery of the material. It is easier to achieve a passing mark if he or she develops an ability to apply their knowledge as required in a clinical setting.”

Recently, both the USMLE Step 1 and COMLEX-USA Level 1 announced a change to a pass/fail scoring system to help reduce test anxiety that students often complained about. But with so much riding on a medical student’s performance these days, it can be crucial to their career plans to adequately prepare for each USMLE or COMLEX exam. Moreover, passing scores eventually lead to the student’s licensure as a doctor.

Failure isn’t the end or the world…

Receiving a “fail” score on the Step 1 or Level 1 exam should not be considered the end of a student’s medical career. So, don’t let it get you down, but use the opportunity to improve on your ability to apply your knowledge. The National Board of Medical Examiners (NBME) that validates allopathic candidates and the National Board of Osteopathic Medical Examiners (NBOME) both permit students to retake the exams after a failed attempt.

The NBME permits students to retake the USMLE Step 1 a maximum of six times. After your first failed attempt, you may retake the exam twice within one year. If you don’t pass on your third attempt, you will have to wait six months. Candidates taking COMLEX-USA examinations are limited to a total of four attempts for each licensure examination required by the NBOME. However, candidates who have passed any exam level are not permitted to retake it to improve their score.

There has been much written about the NBME and NBOME decisions to change from providing numeric scores for the USMLE Step 1 and COMLEX-USA Level 1 examinations respectively, to a PASS/FAIL scoring system. Some residency program directors feel scores on second exams for both allopathic and osteopathic med students may become the standard for the National Residency Matching Program to measure and compare applicants for interviews and their eventual match.

Managing Exam Challenges

Everyone experiences moments of self-doubt, but it’s critical not to let these doubts undermine your performance. Challenges, like licensure exams, can lead to existential thoughts about one’s life path. Whereas relying solely on emotion or intuition for decision making is common, recognizing the obstacles you will face as a practicing physician can empower you to better prepare and develop realistic strategies for overcoming them.

One way to combat self-doubt is through positive self-talk and affirmations. Remind yourself of your past successes and strengths and use them as motivation to tackle other challenges that come your way. After all, a doctor’s life is going to give you much harder times than passing the Step 1 or Level 1 board exams. So, except the fact these intense one-day exams cover a breadth of topics and perhaps more daunting than the test are the months of preparation prior to your test date.

“Self-doubt can fuel a defeatist attitude about taking your board exams,” explains Dr. Wolf. “That’s why I invested years in developing a review program that goes beyond memorization. The Power 5 approach helps students apply the ‘how and why’ to medical concepts based on the knowledge they have.” WOLFPACC provides students with the learning resources needed to prevent exam prep from feeling like an uphill battle.

Fine Tuning Your Mindset for Positive Results

Maintaining a calm and focused state of mind is vital for effective studying. Through the unique approach incorporated into WOLFPACC’s USMLE Step 1 and COMLEX-USA Level 1 review programs, student’s learn how to think their way through each exam question in order to identify the correct answer. Our well-rounded approach gives students the confidence to fill-in the gaps to support what they’ve learned and avoid selecting the wrong answers.

While helping students to succeed in their medical careers, Dr. Wolf saw a need for “The Power 5” method that focuses on the common links between organ systems. By concentrating on pertinent materials learned during the first two years of basic sciences, students find they have a better understanding of the patient as a total unit rather than just focusing on a single presenting sign or symptom. This surprising symmetry allows the test taker to put a clinical understanding to the question at hand.

Allopathic Medical Exams

The National Board of Medical Examiners, established in 1915, is a vital organization in the United States that plays a crucial role in the development and administration of medical examinations. The NBME’s core objective, set at its inception, was to standardize the qualification process across states for medical practice. In the early 1990s, it launched the USMLE examination program, in conjunction with the Federation of State Medical Boards (FSMB), replacing former examinations like NBME Part Examination and the FLEX program.

Today the USMLE managed by NBME remains an authoritative measure for medical licensing in the U.S. The NBME has expanded its services to include various assessments throughout the medical education lifecycle, while serving both students and practicing healthcare professionals. Their mission extends to ensuring public health protection through comprehensive evaluation of health professionals. The USMLE has no age restrictions and is open to current or medical school graduates, provided their school meets ECFMG eligibility.

Osteopathic Medical Exams

Established in 1934, the National Board of Osteopathic Medical Examiners, originally the National Board of Examiners for Osteopathic Physicians and Surgeons, aims to protect public health by evaluating the competencies of osteopathic medical students through assessments using COMLEX-USA Level examinations. Although the COMLEX and the USMLE licensure exams are similar in that they assess clinical fundamentals, COMLEX-USA additionally tests osteopathic principles.

In 1981 the COMLEX-USA sequence was introduced. It was founded on the notion that medical problems should not be compartmentalized into organ systems or disciplines, but rather based on the knowledge and tasks a physician needs to solve them. This requires understanding disease prevention, health promotion, and healthcare delivery systems with a significant emphasis on Osteopathic Manipulative Medicine (OMM). Eligibility for the COMLEX-USA requires an attestation of good standing from a medical school or residency program.

NOTE: Only six states, including California, Florida, Oklahoma, Michigan, Pennsylvania, and West Virginia, specifically require COMLEX-USA for initial DO licensure. All other state boards currently accept the USMLE as well.

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At WOLFPACC, we believe in your dream and want you to become a confident clinical physician. Our staff will do everything we can to help you understand the material presented and to assist you in passing your exam with an impressive score. Dr. Wolf and his staff look forward to working with you. Call today and learn more about our strategic approach to preparing for medical licensure examinations.